The Role of Dexmedetomidine as an Additive to Intravenous Regional Anesthesia: A Systematic Review and Meta-analysis.

Background: Intravenous Regional Anesthesia (IVRA) is a reliable and cost-effective anesthetic method for minor surgical procedures to the extremities. Limitations of this block include tourniquet discomfort, short duration of anesthesia, and absence of postoperative analgesia. Dexmedetomidine has been used as an adjuvant to minimize these negative characteristics with inconclusive results.

Effect of Triiodothyronine Administration on the Kidney During Haemorrhagic Shock and Resuscitation.

Objective: Apoptosis, measured via caspase activity, can be used to assess renal tissue damage in haemorrhagic shock. We investigated whether Triiodothyronine could attenuate apoptosis and protect against haemorrhagic shock-induced renal injury.

Methods: Haemorrhagic shock was induced in swine until the mean arterial pressure (MAP) was 35-40 mmHg for 40 minutes.

Pelvic Exenteration Put into Therapeutical and Palliative Perspective: It Is Worth to Try.

Pelvic exenteration (PE) is one of the most drastic operations in surgical oncology, associated with severe morbidity and mortality. The objective of our study was to review our experience of PE in terms of surgical characteristics, complications, and overall survival. All patients who had PE surgery between January 1999 and December 2015 were identified.

N-Acetylcysteine and Desferoxamine Reduce Pulmonary Oxidative Stress Caused by Hemorrhagic Shock in a Porcine Model.

Aim Of The Study: To investigate the pulmonary oxidative stress and possible protective effect of N-Acetylcysteine (NAC) and Desferoxamine (DFX)in a porcine model subjected to hemorrhagic shock.

Materials And Methods: Twenty-one pigs were randomly allocated to Group-A (sham, n = 5), Group-B (fluid resuscitation, n = 8) and Group-C (fluid, NAC and DFX resuscitation, n = 8). Groups B and C were subjected to a 40-min shock period induced by liver trauma, followed by a 60-min resuscitation period.

Beyond Preconditioning: Postconditioning as an Alternative Technique in the Prevention of Liver Ischemia-Reperfusion Injury.

Liver ischemia/reperfusion injury may significantly compromise hepatic postoperative function. Various hepatoprotective methods have been improvised, aiming at attenuating IR injury. With ischemic preconditioning (IPC), the liver is conditioned with a brief ischemic period followed by reperfusion, prior to sustained ischemia.

The effects of antioxidants on a porcine model of liver hemorrhage.

Purpose: The aim of this study is to assess the efficacy of the combination of N-acetylcysteine (NAC) and deferoxamine (DFO) in the resuscitation from hemorrhagic shock in a porcine model of bleeding during hepatectomy.

Methods: Twenty-one pigs were divided randomly to three groups: Sham (S) group, n = 5; fluid (F) resuscitation group, n = 8; and fluid plus NAC plus DFO (NAC&DFO) resuscitation group, n = 8. The animals of groups F and NAC&DFO were subjected to left hepatectomy and controlled hemorrhage from the traumatic liver surface.

The effects of hemorrhagic shock secondary to hepatectomy in a swine model.

Background: Ischemia-reperfusion injury caused by severe hemorrhagic shock and subsequent resuscitation leads to deterioration of hepatic homeostasis and possibly to liver failure. The present study focuses on determining whether there is a different biological response to hemorrhagic shock by different sources of hemorrhage, hepatic hemorrhage (HH) versus peripheral hemorrhage.

Methods: Twenty-one male swine (Sus scrofa domesticus) were randomly allocated in three groups as follows: sham group (S, n = 5), central venous hemorrhage group, (CVH) (n = 8), and HH group (n = 8).

Perioperative management and outcome of patients with Rett syndrome undergoing scoliosis surgery: a retrospective review.

Background: Rett syndrome is a rare genetically inherited neuromuscular disorder exclusively affecting female patients. Progressive scoliosis is one of the main features of the disease and affected individuals are very likely to need spine correction surgery.

Methods: We undertook a retrospective notes review of patients with Rett syndrome who had undergone spine surgery from 2005 to 2013.

Sildenafil attenuates hepatocellular injury after liver ischemia reperfusion in rats: a preliminary study.

We evaluated the role of sildenafil in a rat liver ischemia-reperfusion model. Forty male rats were randomly allocated in four groups. The sham group underwent midline laparotomy only.

Intravenous lidocaine does not affect the anesthetic depth during rapid sequence induction and intubation as assessed by Bispectral Index monitoring: a randomized double blind study.

Introduction: We investigated the impact of intravenous lidocaine on anesthetic depth, as assessed by Bispectral Index score (BIS), and hemodynamic responses to rapid sequence induction/intubation.

Material And Methods: Eighty-four surgical patients with risk factors for regurgitation/aspiration were randomized to receive either lidocaine 1.5 mg/kg or normal saline in a double-blind fashion.

Impact of thyroid hormone administration on fluid requirements and hepatic injury markers in hemorrhagic shock due to liver trauma.

Introduction: The aim of the present study was to evaluate the effect of triiodothyronine (T3) administration in a porcine model of hemorrhagic shock due to liver surgery, in terms of hemodynamic stability, acid-base status, and hepatic injury markers.

Materials And Methods: Hemorrhagic shock was induced in swine by left lobe liver resection and allowed bleeding to a mean arterial pressure of 35-40 mmHg for 40 min. Animals were randomly assigned into a sham group (n = 5), a fluid-resuscitated group (n = 7), and a fluid plus T3-resuscitated group (n = 7).

Multiple sclerosis: basic knowledge and new insights in perioperative management.

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system affecting young adults that may lead to significant disability. The clinical course varies among the types of the disease as well as among individuals. Herein we provide a brief review of the recent data concerning the clinical presentation, diagnosis, causes, and pathogenesis of MS as well as medication used, followed by the anesthetic considerations of patients diagnosed with the disease.

Resuscitation after hemorrhagic shock: the effect on the liver--a review of experimental data.

The liver is currently considered to be one of the first organs to be subjected to the hypoxic insult inflicted by hemorrhagic shock. The oxidative injury caused by resuscitation also targets the liver and can lead to malfunction and the eventual failure of this organ. Each of the various fluids, vasoactive drugs, and pharmacologic substances used for resuscitation has its own distinct effect(s) on the liver, and the anesthetic agents used during surgical resuscitation also have an impact on hepatocytes.

Sevoflurane versus propofol anesthesia in patients undergoing lumbar spondylodesis: a randomized trial.

Background: Spondylodesis is a procedure aiming at providing stability in one or more spinal segments. The aim of our study was to compare sevoflurane and propofol as induction and maintenance agents, focusing on hemodynamic stability, recovery characteristics, postoperative nausea and vomiting, and pain intensity.

Materials And Methods: Seventy patients, with a physical status according to American Society of Anesthesiologists (ASA) I-II, 50-72 y old, undergoing selective lumbar spondylodesis were enrolled.

Small liver remnants are more vulnerable to ischemia/reperfusion injury after extended hepatectomies: a case-control study.

Background: There is evidence that small-for-size liver grafts are more vulnerable to ischemia/reperfusion injury after liver transplantation. We hypothesized that ischemic injury is more pronounced in small liver remnants after major hepatectomies.

Methods: Fifteen patients underwent extended hepatectomy with remnant liver mass less than 30% of standard liver weight (study group).

Ischemia/reperfusion injury in liver resection: a review of preconditioning methods.

Ischemic preconditioning is one of the therapeutic interventions aiming at preventing ischemia/reperfusion-related injury. Numerous experimental studies and a few clinical series have shown that during liver resections, ischemic preconditioning is a promising strategy for optimizing the postoperative outcome. Moreover, various types of pharmacological intervention as well as different types of preconditioning, such as remote preconditioning, the use of heat shock, and hyperbaric oxygen, have been developed to attenuate the functional impairment accompanying ischemia/reperfusion injury.

Management of idiopathic intracranial hypertension in parturients: anesthetic considerations.

Purpose: Idiopathic intracranial hypertension (IIH) is a rare condition characterized by raised intracranial pressure (ICP) without related pathology in either the brain or the composition of cerebrospinal fluid (CSF). Herein, we provide a brief review of the clinical presentation of IIH and the anesthetic considerations in parturients diagnosed with the disorder.

Source: We conducted a MEDLINE® literature search for all types of articles published in English with restriction for year of publication, and we used the search terms "idiopathic intracranial hypertension", "pseudotumor cerebri", "benign intracranial hypertension", "pregnancy", "cesarean section", "labour analgesia", "epidural", and "anesthesia".